尿动力学参数能否预测经尿道中段吊带术后持续性压力性尿失禁？一项系统评价。
Do urodynamic parameters predict persistent postoperative stress incontinence after midurethral sling? A systematic review.
作者信息
Kawasaki Amie, Wu Jennifer M, Amundsen Cindy L, Weidner Alison C, Judd John P, Balk Ethan M, Siddiqui Nazema Y
机构信息
Department of Obstetrics & Gynecology, Division of Urogynecology, Duke University Medical Center, 5324 McFarland Drive, Suite 310, Durham, NC 27707, USA.
出版信息
Int Urogynecol J. 2012 Jul;23(7):813-22. doi: 10.1007/s00192-012-1693-3. Epub 2012 Mar 9.
INTRODUCTION AND HYPOTHESIS
It is unclear whether preoperative urodynamic study (UDS) values are predictive of outcomes after midurethral sling.
MATERIALS AND METHODS
We systematically reviewed multiple databases from January 1989 to October 2011 for English-language studies correlating UDS data with postoperative outcomes after midurethral slings. We performed random effects model meta-analyses, as indicated. Relative risk (RR) ratios for the outcome of stress urinary incontinence (SUI) cure were calculated using high maximum urethral closure pressure (MUCP) and Valsalva leak point pressure (VLPP) values as the reference group.
RESULTS
High preoperative MUCP was associated with cure after retropubic [RR 0.67; 95% confidence interval (CI) 0.47-0.97)] and transobturator slings (RR 0.65; 95% CI 0.49-0.90). High preoperative VLPP was also associated with cure after retropubic sling (RR 0.89; 95% CI 0.82-0.96), but this relationship did not achieve statistical significance for cure after transobturator sling (RR 0.86; 95% CI 0.74-1.00).
CONCLUSIONS
Preoperative MUCP and VLPP values may add insight into postoperative outcomes after surgical treatment for SUI.
引言与假设
术前尿动力学研究（UDS）值是否能预测中段尿道吊带术后的结果尚不清楚。
材料与方法
我们系统检索了1989年1月至2011年10月期间的多个数据库，以查找将UDS数据与中段尿道吊带术后结果相关联的英文研究。我们按指示进行了随机效应模型的荟萃分析。以高最大尿道闭合压（MUCP）和瓦尔萨尔瓦漏尿点压（VLPP）值作为参照组，计算压力性尿失禁（SUI）治愈结果的相对风险（RR）比率。
结果
术前高MUCP与耻骨后吊带术后治愈相关（RR 0.67；95%置信区间[CI] 0.47 - 0.97）以及经闭孔吊带术后治愈相关（RR 0.65；95% CI 0.49 - 0.90）。术前高VLPP也与耻骨后吊带术后治愈相关（RR 0.89；95% CI 0.82 - 0.96），但这种关系在经闭孔吊带术后治愈方面未达到统计学显著性（RR 0.86；95% CI 0.74 - 1.00）。
结论
术前MUCP和VLPP值可能有助于深入了解SUI手术治疗后的术后结果。
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